Carotid artery distension predicts coronary events
By Martha Kerr
16 july 2008--Ultrasound imaging is a simple, noninvasive way to detect distension of the carotid arteries - the arteries that pass through the neck to supply the brain with oxygen -- which is an independent predictor of coronary heart disease (CHD) in the elderly, French researchers report in the current issue of Arteriosclerosis, Thrombosis, and Vascular Biology.
The mechanical properties of arteries appear to be intrinsically involved with coronary artery health. To assess the predictive value of carotid wall mechanics for CHD, Dr. Nathalie Leone of the Faculte de Medecine Xavier Bichat in Paris and colleagues in the Three-City Study (Bordeaux, Dijon, and Montpellier) performed carotid ultrasound imaging on 3,337 individuals 65 years or older.
The investigators used B-mode ultrasound to examine the carotid arteries, which is a valid and reproducible method of assessing carotid distension, Leone commented in an interview with Reuters Health. It could be used to supplement the major traditional risk factors, such as tobacco consumption, high blood pressure, high cholesterol and diabetes, to identify high-risk individuals, she added.
The average follow-up time was 43.4 months, during which there were 1,278 CHD events.
The team found that carotid distension -- the relative change in the diameter of the artery -- was "significantly associated" with CHD risk. Patients with the highest scores had an 80 percent greater risk of CHD compared with those with the lowest scores.
While the build-up of plague in the arteries (atherosclerosis) was linked to carotid distension, it was not an independent risk factor for coronary events.
Whether local blood pressure is a cause or a consequence of carotid distension is also unclear, she added.
Beta-blocker therapy is not advisable in these patients, Leone and colleagues caution. They note that "by decreasing heart rate, beta-blocking agents may enhance the magnitude of arterial distension."
Beta-blockers will not work as well as angiotensin-converting enzyme inhibitors or calcium antagonists in these patients, they add.
SOURCE: Arteriosclerosis, Thrombosis, and Vascular Biology, July 2008.
The mechanical properties of arteries appear to be intrinsically involved with coronary artery health. To assess the predictive value of carotid wall mechanics for CHD, Dr. Nathalie Leone of the Faculte de Medecine Xavier Bichat in Paris and colleagues in the Three-City Study (Bordeaux, Dijon, and Montpellier) performed carotid ultrasound imaging on 3,337 individuals 65 years or older.
The investigators used B-mode ultrasound to examine the carotid arteries, which is a valid and reproducible method of assessing carotid distension, Leone commented in an interview with Reuters Health. It could be used to supplement the major traditional risk factors, such as tobacco consumption, high blood pressure, high cholesterol and diabetes, to identify high-risk individuals, she added.
The average follow-up time was 43.4 months, during which there were 1,278 CHD events.
The team found that carotid distension -- the relative change in the diameter of the artery -- was "significantly associated" with CHD risk. Patients with the highest scores had an 80 percent greater risk of CHD compared with those with the lowest scores.
While the build-up of plague in the arteries (atherosclerosis) was linked to carotid distension, it was not an independent risk factor for coronary events.
Whether local blood pressure is a cause or a consequence of carotid distension is also unclear, she added.
Beta-blocker therapy is not advisable in these patients, Leone and colleagues caution. They note that "by decreasing heart rate, beta-blocking agents may enhance the magnitude of arterial distension."
Beta-blockers will not work as well as angiotensin-converting enzyme inhibitors or calcium antagonists in these patients, they add.
SOURCE: Arteriosclerosis, Thrombosis, and Vascular Biology, July 2008.
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